Last modified: 2023-02-09
Abstract
Background: The 2020-2035 Health extension program optimization roadmap prioritized performance management (PM) and performance-based incentive (PBI) for re-vitalizing the program; improving health extension workers’ (HEWs) performance; improving reproductive, maternal, newborn and child health (RMNCH) services and its outcomes. JSI-L10K through CIFF funding supports the MoH by designing and implementing digitally enabled PM and PBI interventions on electronic community health information system (eCHIS) for roadmap realization.
Objective: To assess implementation of PM and PBI interventions in six woredas.
Method: JSI-L10K is implementing PM and PBI in six woredas (3 PM and 3 PBI); 33 health centers (HC) and 186 health posts (HP) in Amhara, Oromia and SNNP regions. Digitally enabled, Equipped, Supervised and Compensated (DESC) framework has been used for developing implementation strategies and monitoring progresses. Project team collected data from HC supervisors and HEWs working in 16 HCs and 24 HPs in November 2022 using semi-structured standardized checklist. Data was entered into google forms and analyzed using descriptive statistics.
Result: All HC supervisors and 96% of the HEWs in the PBI sites know about PBI. Of the HC supervisors, 81% started using the enhanced Focal Person Application (FPA) features, i.e. 45% used the supervisory task manager, 75% the plan setting manager and 32% the PM dashboard. In the past three months, 54% of the HCs provided monthly mentorship to their catchment HPs and 88% of the HCs organized a monthly review meeting. In PM Woredas 96% of the HPs, completed population registration on eCHIS and 75% of them were verified by their cluster HC. In PBI sites, 82% of the HPs completed population registration, and 26% were verified by their cluster HCs. Of the visited HPs in PM and PBI woredas, 28% and 33% of the HPs had PM/PBI implementation guides respectively. All health facilities had at least two HEWs having basic eCHIS training, 92% of the HEWs had functional tablets.
Conclusion: There has been commendable progress in digitally enabled PM and PBI interventions. Identified implementation gaps in tablets functionality, household and member registration, mentorship, supervision, and FPA features usage need to be addressed to ensure success.
Key Words: Ethiopia, eCHIS, Implementation, Performance Management, Performance Based Incentive.